Peptic Ulcer Near the Pylorus

Abstract

Summary 1.A study has been made of surgically treated peptic situated near the pylorus, with special reference to so-called pyloric-channel ulcer. 2.The pyloric channel is not a well-delineated anatomic entity. Its proximal boundary is arbitrarily determined. For the purposes of this study the pyloric channel is judged to be bounded distally by the gastroduodenal junction (as delineated microscopically) and proximally by a line encompassing the 2 cm. above this junction. 3.The symptomatologic aspects of a small group of peptic ulcers localized to the pyloric channel did not differ sufficiently from those caused by gastric situated above the pyloric channel or from those of duodenal to permit delineation of a specific and useful clinical syndrome. 4.Although the roentgenologic localization of peptic ulcers generally is highly accurate, peptic ulcers located near the pyloric sphincter often are not accurately defined as gastric or duodenal by the roentgenologist. 5.Clinical and surgical series of so-called pyloric-channel ulcers are not homogeneous groups, probably include prepyloric gastric ulcers, duodenal ulcers and pyloroduodenal ulcers. It is suggested that the simpler designation of ulcer at or near the pylorus has merit when peptic ulcers located near the pyloric sphincter are being discussed.